A 36-year-old man arrived at a hospital in South Africa with a painful swelling on the right side of his lower chest and abdomen that had been draining pus, on and off, for three months. He was already being treated for pulmonary tuberculosis. What his surgeons eventually removed from him was a handful of nails.
His case opens a three-patient series on acuphagia published in the South African Journal of Surgery. Acuphagia is the intentional swallowing of sharp metal objects, a form of pica that surgeons rank among the riskiest things a person can put into the gastrointestinal tract. The strangest detail in the case arrived after the operation rather than before it.
